Top 300 Pharmacy Drug Cards

LANSOPRAZOLE: Prevacid, Various

Class: Proton Pump Inhibitor

Dosage Forms. Capsule, Delayed Release: 15 mg, 30 mg; Disintegrating Tablet: 15 mg, 30 mg; Powder for Suspension: 3 mg/mL

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Common FDA Label Indication, Dosing, and Titration.

1. Duodenal ulcer disease: 15 mg po daily × up to 4 wk

2. Gastric ulcer disease, treatment: 30 mg po daily × up to 8 wk

3. Helicobacter pylori gastrointestinal tract infection, triple therapy: 30 mg po bid × 10-14 d in combination with amoxicillin 1000 mg and clarithromycin 500 mg po bid

4. Erosive esophagitis, gastroesophageal reflux disease, treatment: Children 1-11 y old and 30 kg or less, 15 mg po daily × 12 wk; Children >30 kg, 30 mg po daily × 12 wk; Children 12 y and older and Adults, 30 mg po daily × 8-16 wk

5. Zollinger-Ellison syndrome: 60 mg po bid up to 180 mg/d

Off-Label Uses.

1. Heartburn: 15 mg po daily for up to 14 d

2. Drug-induced gastrointestinal disturbance: 15 mg po daily

MOA. Lansoprazole is a proton pump inhibitor (PPI) that, when protonated in the secretory canaliculi of the parietal cells, covalently binds to H+/K+-ATPase (proton pump), which is the final pathway for acid secretion.

Drug Characteristics: Lansoprazole

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Medication Safety Issues: Lansoprazole

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Drug Interactions: Lansoprazole

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Adverse Reactions: Lansoprazole

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Efficacy Monitoring Parameters. Resolution of GI discomfort, resolution of ulcers shown on endoscopy; for treatment of H pylori, negative urea breath test.

Toxicity Monitoring Parameters. Seek medical attention if severe headache or blistering skin rash occurs.

Key Patient Counseling Points. Should be taken on an empty stomach 1 h before eating. Should not be taken with antacids.

Clinical Pearls. Multiple H pylori regimens exist that include different combinations of PPIs and antibiotics; counsel patient to complete full regimen if prescribed for H pylori management. Other PPI and H2 antagonists available OTC; warn patients not to take multiple products concurrently to avoid additive risk of adverse effects. Increased risk of bone fracture with long term use, use with caution in those with osteoporosis. Medication guide required at dispensing.